Monthly Archives: November 2014

Supports for family members in grief

Basic & General, Issues & Debates

Sometimes when we don’t hear from a patient for long, we’ll start worrying about them, especially if they are depressed, or worse, with suicidal caution. But too many patients come and go every day in the clinic, it could be difficult to remember everyone.

Sometimes I think we wouldn’t even know if and when a patient ends his or her life, unless we read it from the news or the family member contacts us.

Yes family member does contact us and tell us about the news when it happens, not all the time, but they do. And one main reason they usually call us and inform us regarding the patient’s suicide, is that they want to question us.

“He’s been taking the medicine prescribed by the doctor regularly, how did this still happen?”

“How come the medicine he was prescribed with wasn’t helping?”

“The last time when she went to your clinic, did doctor say anything? Did she say anything?”

Yes, I understand this and that (sometimes I think they just need someone or something to point their fingers at). But we’re only an outpatient clinic, all we can do is not much, though we do try our best including using phone calls or emails to reach and support them in their daily lives.

The sister was in tears when she called. The last time I heard from the sister was almost a year ago. She said he’s gone, their brother, the six sisters’ one and only brother. He jumped off from the balcony of an apartment.

They still couldn’t accept the truth.

And no, she didn’t call to question us, to blame it on us. She called to ask if she and the other sisters should come for an appointment as they are all feeling really low and depressed.

She was explained that they can certainly come for an appointment if they feel the need, but this is part of grieving, absolutely normal for people to feel depressed, guilty, lost, empty, angry … And the duration of this period could be few weeks, or even up to few years (some research suggested 4 years as an average of grieving period after losing a love one). Some people can function absolutely well during this period (though never take that these people are cold-blooded, they just deal with loss differently) while some need to take some time off or even go for professional counselling services or help.

Sometimes it’s the part that we often overlook – the needs of the immediate carers and family members of our patients – alive or dead.

Learn about this man’s obsession

Anxiety Disorder, Clinical Case Studies, Obsession & Compulsion

WARNING: You may not want to read this while you’re eating.

At first it seems a bit difficult to diagnose what problem he has, other than not being able to sleep well for the past year.

He’s working in KL on his own while all his family are in Penang. He has one daughter and one son, both married with children. He said that he’s in good contact with all the family members, and he goes back to see them often, sometimes they would also come to see him. He is cheerful, and seems very sociable.

Apart from his sleeping problems (the reason he came to our clinic), he also kept mentioning that he has constipation. We’d have thought that this is not directly related to mental health problems, but he said he has had check up, test and scans, and was told that he’s absolutely fine. So why constipation?

When he started to talk about his problems in passing faeces in details, the answer slowly revealed. He said people should at least pass 1 kilogram of faeces every day, not anything less than that, “this morning I passed only 200 grams, that is not good enough, and that would keep me worried all day” (Please don’t ask me how he measures that, I hope he’s just checking his own weight before and after the business. And by the way, how does 1 kg of faeces look?). He does everything he can to improve his bowel movements, but still, he thinks he has constipation.

And it’s kind of difficult for him to have insight about his obsessions. Now he’s being treated for his insomnia, and secretly and hopefully, also for his OCD.

Though we have come across and read about all kind of obsessions, this is still quite distinct and… peculiar.

How much courage does one need to jump off a building?

Clinical Case Studies, Issues & Debates, Schizophrenia & Psychotic Disorder

There are various ways people can use to end their lives, but when it comes to jumping from height, it always makes me wonder how much courage it requires to take that step, and do they regret as they are falling down before hitting the ground? Are they terrified? Do they think about going back?

This is the third patient in the past 3 weeks.

The first two both were longstanding depressed patients, both had attempted suicide in their history, so though it was heartbreaking, at least it didn’t shock us as much as the one who chose to jump off from an apartment far away from his house this week.

He had been diagnosed with paranoid schizophrenia for years. Never a negative person, he could function well in work and with family, maintaining with medicine.

Nobody would have anticipated that. Not even his caring sister. And with the method he chose to terminate his life, he does show how determined he was.

So never think that people with depression are the only ones who would attempt suicide.

So never think that those who think about suicide would always mention it before the attempts.

So never think that long-term mentally ill patient without previous suicide attempt are very unlikely to commit suicide.

Also, never think the reason everyone suffering from mental illness end their lives due to their mental illness, there are still various other possible explanations, and suffering from mental illness, is just one of them.

Please give yourself a second chance. Malaysia suicide hotlines:

The Befrienders
03-7956 8144/ 03-7956 8145
www.befrienders.org.my

Life Line Association Malaysia
03-4265 7995
http://lifeline.org.my/cn/

Agape Counselling Center Malaysia
03-7785 5955 / 03-7781 0800
http://www.agape.org.my

If you come across someone who’s suicidal: https://huibee.com/2020/05/somebody-you-know-is-suicidal/